How long should I persist with Finacea gel 15% when it has given me red bumps on my cheeks and irritation? (photos)

Question

I am being treated for rosacea type 2 with oral doxycycline 100 mg daily and 15% finacea gel daily. Since starting the Finacea (have been using about 3 weeks), my rosacea has flared horribly, giving me red bumps on my cheeks, a swollen texture, flaky skin and redness. I actually decreased to only using it every other day for the past week and it just seems to be getting worse. I am tempted to discontinue use, but my doctor said it may take a few weeks to get used to the medication.

Jason Emer, MD · Answer

I recommend getting a formal evaluation with a cosmetic dermatologist. For rosacea, I like a combination approach, using lasers (ProYellow, Pulsed Dye/Vbeam, Excel V, Clear + Brilliant), peels and botox to the cheeks. This makes dramatic changes in color and symptoms. See an expert. Best, Dr. Emer

Melvin Elson, MD · Answer

It may take a while for the medication to settle in but this seems excessive. Be sure you are seeing a board certified dermatologist and if so take his advice

Davin Lim, MBBS, FACD - Account Suspended · Answer

As advisors we have to be respectful of your doctors decision - so if your specialist is a dermatologist, he or she would know your skin better than any of us. Personally I would stop for 7 days, reduce inflammation, then titrate the topicals in. 
Rosacea is very complex and a tailored treatment program give the best results. This is because there are many types of rosacea (telengtctatic or capillaries, flushing and redness, acne like rosacea, ocular rosacea and even rhinophyma rosacea.)

To add to the complexity, everyone has different flare factors- Sunlight, stress, foods, chemical irritants, creams, changes in temperature, alcohol. The list goes on. A good website that educates you about rosacea is rosacea dot org

To help treat your rosacea a detailed history, together an examination is needed. Once this is established a treatment tailored according to YOUR type of rosacea will give the best results. As a guide, I use a combination of -

1. Lasers (to treat redness, broken capillaries, rhinophyma, flushing)- best laser is the V BEAM. IPL- BBL  can be used, but usually not as effective. Laser toning using the long pulse Nd Yag at 1064 can help with background redness.

2. Creams - anti inflammatory- Rozex, Azalelic acid, Solantra. Creams are effective in 30% of cases.

3. Tablets -anti - inflammatory and sometimes low dose Vitamin A. Vitamin A cream can be used in very low concentration and gradually titrated. See a medical dermatologist for this.

4. For females- Mineral make up is recommend- paraben and preservative – talc free.

For the best results, be holistic in your approach, start off with the foundations of rosacea management, - avoiding flare factors, use of anti- inflammatory agents, and then progress to

consult a dermatologist for both medical and laser treatment options,

Kind regards.

Dr Davin S. Lim.

Laser Dermatologist.

Brisbane, Australia. Real Self Advisory Board.

How long should I persist with Finacea gel 15% when it has given me red bumps on my cheeks and irritation? (photos)

Answers (3)

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